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https://www.readbyqxmd.com/read/29030799/gastric-peroral-endoscopic-pyloromyotomy-therapy-for-refractory-gastroparesis
#1
REVIEW
Petros C Benias, Mouen A Khashab
Purpose of review Gastroparesis is a complex dysmotility disorder in which a number of normal gastric emptying mechanisms can be affected. The pylorus as an apparatus is particularly important since it stands as the last final gateway for gastric emptying. As such, pyloric interventions seem to be successful in reducing symptoms and also improving emptying of solids, an effect not observed with other medical interventions. Recent findings Gastric peroral endoscopic myotomy (G-POEM) is a novel technique which offers the promise of mimicking the success of a traditional surgical pyloroplasty, while embracing the minimally invasive paradigm of flexible endoscopic surgery...
October 14, 2017: Current Treatment Options in Gastroenterology
https://www.readbyqxmd.com/read/29024324/clinical-implications-of-gastrointestinal-symptoms-in-systemic-amyloidosis
#2
T Yen, F W Chen, R M Witteles, M Liedtke, L A Nguyen
BACKGROUND: Gastrointestinal (GI) symptoms in systemic amyloidosis patients are poorly characterized. This purpose of this study is to define the epidemiology and clinical implications of such symptoms. METHODS: This was a retrospective cohort study of 583 amyloid patients seen at a tertiary referral center. Of 96 symptomatic patients, 82 received endoscopic biopsies, subsequently grouped into those with histologic evidence of GI amyloid (biopsy proven) vs without (biopsy absent)...
October 10, 2017: Neurogastroenterology and Motility: the Official Journal of the European Gastrointestinal Motility Society
https://www.readbyqxmd.com/read/29017725/appropriateness-of-a-pediatric-specific-enhanced-recovery-protocol-using-a-modified-delphi-process-and-multidisciplinary-expert-panel
#3
Heather L Short, Natalie Taylor, Kaitlin Piper, Mehul V Raval
PURPOSE: Despite Enhanced Recovery After Surgery (ERAS) protocols demonstrating improved outcomes in a wide variety of adult surgical populations, these protocols are infrequently and inconsistently being used in pediatric surgery. Our purpose was to develop a pediatric-specific ERAS protocol for use in adolescents undergoing elective intestinal procedures. METHODS: A modified Delphi process including extensive literature review, iterative rounds of surveys, and expert panel discussions was used to establish ERAS elements that would be appropriate for children...
September 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28994306/pharmacological-treatments-and-infectious-diseases-in-pediatric-inflammatory-bowel-disease
#4
Valeria Dipasquale, Claudio Romano
The incidence of pediatric inflammatory bowel disease (IBD) is rising, as is the employment of immunosuppressive and biological drugs. Most patients with IBD receive immunosuppressive therapies during the course of the disease. These molecules are a double-edged sword; while they can help control disease activity, they also increase the risk of infections. Therefore, it is important that pediatricians involved in primary care, pediatric gastroenterologists, and infectious disease physicians have a thorough knowledge of the infections that can affect patients with IBD...
October 10, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28987263/follow-up-of-the-post-liver-transplantation-patient-a-primer-for-the-practicing-gastroenterologist
#5
REVIEW
Amanda Cheung, Josh Levitsky
The focus in liver transplantation in the next 10 years will likely change from preventing viral disease recurrence to minimizing the toll of rejection and fatty liver disease, minimizing the complications from immunosuppression with withdrawal strategies, and more optimal management of long-term risks, such as malignancy, cardiovascular disease, and renal failure. In addition, now that short-term results (<1 year) have improved significantly, there will be a shift toward improving long-term patient and graft survival, as well as a focus on primary care preventive strategies...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987259/primary-sclerosing-cholangitis-what-the-gastroenterologist-and-hepatologist-needs-to-know
#6
REVIEW
Andrea A Gossard, Gregory J Gores
Primary sclerosing cholangitis (PSC) is a chronic, idiopathic biliary tract disease characterized by segmental strictures. The disease is progressive with no proven treatments and may eventually lead to cirrhosis and end-stage liver disease. Abrupt changes in liver biochemistries, pain, and/or cholangitis may suggest a dominant stricture amenable to endoscopic therapy or the development of cholangiocarcinoma. Patients with PSC are at increased risk of cholangiocarcinoma. There is a strong association with inflammatory bowel disease, and an associated increased risk of colorectal cancer...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28987257/the-liver-in-oncology
#7
REVIEW
Renu Dhanasekaran, Paul Y Kwo
Gastroenterologists and hepatologists will encounter oncology patients who develop abnormal liver tests, patients with hepatic malignancies, and patients with acute and chronic liver disease who require chemotherapy or immediate evaluation. Chemotherapy can cause liver injury owing to toxic effects or idiosyncratic reactions. Immune checkpoint inhibitors may be associated with autoimmune-mediated liver toxicities. Venoocclusive disease requires immediate evaluation. Nodular regenerative hyperplasia is a chronic progressive disorder...
November 2017: Clinics in Liver Disease
https://www.readbyqxmd.com/read/28985688/diagnosis-and-management-of-pancreatic-exocrine-insufficiency-pei-in-primary-care-consensus-guidance-of-a-canadian-expert-panel
#8
P Durie, J-D Baillargeon, S Bouchard, F Donnellan, S Zepeda-Gomez, C Teshima
Pancreatic exocrine insufficiency (PEI) results in maldigestion due to inadequate activity of pancreatic enzymes in the small bowel. PEI can arise from a variety of medical conditions that reduce enzyme synthesis within the pancreatic parenchyma or from secondary factors that may occur despite optimal parenchymal function, such as pancreatic duct obstruction or reduced or poorly synchronized enzyme release. The most characteristic symptom of PEI is steatorrhea - voluminous, lipid-rich stools; other common signs and symptoms include unexplained weight loss and deficiencies of fat-soluble vitamins and other micronutrients...
October 6, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28984754/late-presentation-of-necrotizing-enterocolitis-associated-with-rotavirus-infection-in-a-term-infant-with-hyperinsulinism-on-octreotide-therapy-a-case-report
#9
Abdulaziz A Alsaedi, Ayman A Bakkar, Naglaa M Kamal, Jwaher M Althobiti
RATIONALE: Congenital hyperinsulinism (CHI) is the most common cause of persistent hypoglycemia in infancy that can cause permanent brain damage. Consequently, optimal management is extremely important. Current pharmacologic and surgical treatment were available that included diazoxide and octreotides. PATIENT CONCERNS: A 4 month old Saudi male patient diagnosed at our hospital as CHI, treated with near total pancreatectomy and octreotide therapy of 30 mcg/kg/day presented with severe abdominal distension, vomiting and bloody diarrhea...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28983504/perspectives-on-endoscopic-surveillance-of-dysplasia-in-inflammatory-bowel-disease-a-survey-of-academic-gastroenterologists
#10
Zane R Gallinger, Amir Rumman, Sanjay K Murthy, Geoffrey C Nguyen
BACKGROUND AND STUDY AIMS:  Dye-based chromoendoscopy (DBC) is the preferred method for endoscopic dysplasia surveillance in patients with inflammatory bowel disease (IBD). We sought to examine the uptake of, and perception toward DBC among academic gastroenterologists. METHODS:  We conducted an online survey of academic members of the Canadian Association of Gastroenterology to assess their current dysplasia surveillance practice, uptake of DBC, and perceived barriers to adoption of DBC...
October 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28982819/uk-based-multisite-prospective-cohort-study-of-small-bowel-obstruction-in-acute-surgical-services-national-audit-of-small-bowel-obstruction-nasbo-protocol
#11
Matthew J Lee, Adele E Sayers, Thomas M Drake, Marianne Hollyman, Mike Bradburn, Daniel Hind, Timothy R Wilson, Nicola S Fearnhead
INTRODUCTION: Small bowel obstruction (SBO) is a common indication for emergency laparotomy in the UK, which is associated with a 90-day mortality rate of 13%. There are currently no UK clinical guidelines for the management of this condition. The aim of this multicentre prospective cohort study is to describe the burden, variation in management and associated outcomes of SBO in the UK adult population. METHODS AND ANALYSIS: UK hospitals providing emergency general surgery are eligible to participate...
October 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28981976/inflammatory-bowel-disease-in-chronic-granulomatous-disease-an-emerging-problem-over-a-twenty-years-experience
#12
Giulia Angelino, Paola De Angelis, Simona Faraci, Francesca Rea, Erminia Francesca Romeo, Filippo Torroni, Renato Tambucci, Alessia Claps, Paola Francalanci, Maria Chiriaco, Gigliola Di Matteo, Caterina Cancrini, Paolo Palma, Patrizia D'Argenio, Luigi Dall'Oglio, Paolo Rossi, Andrea Finocchi
BACKGROUND: Chronic Granulomatous Disease (CGD) is a primary immunodeficiency of phagocytes, characterized by life-threatening infections and hyperinflammation. Due to survival improvement, Inflammatory Bowel Disease (IBD) is becoming increasingly relevant. Here we report our 20-year experience. METHODS: We retrospectively analyzed clinical, endoscopic and histologic features, as well as the management of CGD-IBD patients referred to the Bambino Gesù Children's Hospital in Rome, Italy...
October 5, 2017: Pediatric Allergy and Immunology
https://www.readbyqxmd.com/read/28978952/editorial-endoscopic-scoring-systems-in-crohn-s-disease-for-evaluation-of-responsiveness-to-treatment-are-we-ready-for-the-prime-time-of-endoscopic-assessment
#13
Anna M Buchner, Gary R Lichtenstein
There are currently two validated endoscopic indices for evaluation of Crohn's disease (CD), the Crohn's disease Endoscopic Index of Severity (CDEIS) and the Simple Endoscopic Score for Crohn's disease (SES-CD). The study by Khanna et al. evaluated the responsiveness of the SES-CD and CDEIS using data from a trial of adalimumab. The study used appropriate statistical methods to quantify responsiveness of the indices as assessed by blinded central readers. The SES-CD demonstrated numerically greater responsiveness to a treatment of known efficacy, suggestive that the SES-CD is more efficient outcome measure than the CDEIS...
October 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28974896/access-to-biologicals-in-crohn-s-disease-in-ten-european-countries
#14
Márta Péntek, Peter L Lakatos, Talitha Oorsprong, László Gulácsi, Milena Pavlova, Wim Groot, Fanni Rencz, Valentin Brodszky, Petra Baji, Crohn's Disease Research Group
AIM: To analyze access (availability, affordability and acceptability) to biologicals for Crohn's disease (CD) in ten European countries and to explore the associations between these dimensions, the uptake of biologicals and economic development. METHODS: A questionnaire-based survey combined with desk research was carried out in May 2016. Gastroenterologists from the Czech Republic, France, Germany, Hungary, Latvia, Poland, Romania, Slovakia, Spain and Sweden were invited to participate and provide data on the availability of biologicals/biosimilars, reimbursement criteria, clinical practice and prices, and use of biologicals...
September 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28961959/the-expanding-therapeutic-armamentarium-for-inflammatory-bowel-disease-how-to-choose-the-right-drug-s-for-our-patients
#15
Pieter Hindryckx, Niels Vande Casteele, Gregor Novak, Reena Khanna, Geert D'Haens, William J Sandborn, Silvio Danese, Vipul Jairath, Brian G Feagan
The therapeutic landscape for inflammatory bowel disease (IBD) is rapidly evolving. Two new biologic drugs, vedolizumab and ustekinumab, have recently entered the marketplace, the first biosimilars have been introduced, and several other agents are at an advanced stage of clinical development. In parallel, therapeutic goals have shifted from symptom control towards mucosal healing and prevention of bowel damage. In the coming years, gastroenterologists will be faced with unprecedented choices when selecting the best treatment for their patients with IBD...
August 25, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28961891/establishing-key-performance-indicators-kpis-and-their-importance-for-the-surgical-management-of-inflammatory-bowel-disease-results-from-a-pan-european-delphi-consensus-study
#16
Pritesh S Morar, James Hollingshead, Willem Bemelman, Nick Sevdalis, Thomas Pinkney, Graeme Wilson, Malcolm Dunlop, R Justin Davies, Richard Guy, Nicola Fearnhead, Steven Brown, Janindra Warusavitarne, Cathryn Edwards, Omar Faiz
Background and Aims: Key performance indicators [KPIs] exist across a range of areas in medicine. They help to monitor outcomes, reduce variation, and drive up standards across services. KPIs exist for inflammatory bowel disease [IBD] care, but none specifically cover inflammatory bowel disease [IBD] surgical service provision. Methods: This was a consensus-based study using a panel of expert IBD clinicians from across Europe. Items were developed and fed through a Delphi process to achieve consensus...
July 20, 2017: Journal of Crohn's & Colitis
https://www.readbyqxmd.com/read/28957967/introduction-of-the-nurse-endoscopist-role-in-one-australian-health-service
#17
Nerissa Duncan, Deanne Bonney, Catherine Au, Cheyne Chalmers, Paul N Bennett
In Australia, nurses performing endoscopic procedures is a recent phenomenon and is uncommon. Challenges include gastroenterologist and patient acceptance of the nurse endoscopist role. This article aims to explore Monash Health's experience with the introduction of a nurse endoscopist. A nurse endoscopist trainee undertook a comprehensive training program under the supervision of a gastroenterologist. All procedural data were collected, organizational policy and procedures were developed, and patients (n = 40) completed a telephone interview postprocedure...
September 2017: Gastroenterology Nursing: the Official Journal of the Society of Gastroenterology Nurses and Associates
https://www.readbyqxmd.com/read/28951581/acute-graft-versus-host-disease-of-the-gut-considerations-for-the-gastroenterologist
#18
REVIEW
Steven Naymagon, Leonard Naymagon, Serre-Yu Wong, Huaibin Mabel Ko, Anne Renteria, John Levine, Jean-Frederic Colombel, James Ferrara
Haematopoietic stem cell transplantation (HSCT) is central to the management of many haematological disorders. A frequent complication of HSCT is acute graft-versus-host disease (GVHD), a condition in which immune cells from the donor attack healthy recipient tissues. The gastrointestinal system is among the most common sites affected by acute GVHD, and severe manifestations of acute GVHD of the gut portends a poor prognosis in patients after HSCT. Acute GVHD of the gastrointestinal tract presents both diagnostic and therapeutic challenges...
September 27, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28951114/italian-society-of-digestive-endoscopy-sied-position-paper-on-the-non-anaesthesiologist-administration-of-propofol-for-gastrointestinal-endoscopy
#19
Rita Conigliaro, Lorella Fanti, Mauro Manno, Piero Brosolo
Propofol sedation by non-anesthesiologists in GI endoscopy, despite generally considered a safe procedure, is still a matter of debate. Benefits of propofol sedation include rapid onset of action, greater patient comfort and fast recovery with prompt discharge from the endoscopy unit. The use of propofol for sedation in GI endoscopy, preceded by dedicated training courses, has been approved by several anaesthesiologist and gastroenterologist societies but an Italian position paper taking into account the Italian law is lacking...
September 5, 2017: Digestive and Liver Disease
https://www.readbyqxmd.com/read/28943113/gastroesophageal-reflux-disease-a-clinical-overview-for-primary-care-physicians
#20
REVIEW
Sudha Pandit, Moheb Boktor, Jonathan S Alexander, Felix Becker, James Morris
OBJECTIVE: GERD is among the most common outpatient disease processes encountered by clinicians on a daily basis. This review provides insights about how to approach GERD in terms of disease management and treatment. METHODS: Review articles were searched using PUBMED and MEDLINE using criteria that included English language articles published in the last 5 years concerning studies carried out only in humans. The key words used in the searches were GERD, PPI, and erosive esophagitis...
September 11, 2017: Pathophysiology: the Official Journal of the International Society for Pathophysiology
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